OBJECTIVETo investigate the potential therapeutic effect of tamoxifen in treating abnormal skin scar contraction.

METHODSFibroblast-populated collagen lattices, which were made by embedding human dermal fibroblasts within type I collagen forming a three-dimensional culture system, were used as an invitro model. Then media either without or with addition of tamoxifen from 1 mumol/L to 50 mumol/L were added to the collagen lattices. Lattice areas were measured at intervals to assess the influence of tamoxifen on the lattice contraction. To visualize changes in the morphology and vitality of fibroblasts, MTT was added to the lattices.

RESULTSTamoxifen had an inhibitory effect on lattice contraction by a dose- and time-dependent pattern. 5 mumol/L or less of tamoxifen didn't show any influence on lattice contraction but 30 mumol/L or higher completely inhibited contraction. At intermediate concentrations from 10 mumol/L to 20 mumol/L the degree of lattice contraction was dose- and time-dependent, which was demonstrated by the reversibility of inhibition. Both the inhibition of contraction and the reversibility of inhibition appeared to correlate with changes in fibroblast morphology.

CONCLUSIONTamoxifen could inhibit the contraction of fibroblast-populated collagen lattices, indicating that tamoxifen may have potential effect on abnormal scar contraction in vivo.

Cicatrix ; drug therapy ; Collagen ; physiology ; Dose-Response Relationship, Drug ; Fibroblasts ; drug effects ; physiology ; Humans ; Skin ; cytology ; drug effects ; Tamoxifen ; pharmacology ; therapeutic use ; Time Factors

INTRODUCTION: The COVID-19 pandemic forced Philippine medical schools to adapt their curriculum design to fit an online setup. This study aimed to analyze and interpret the lived experiences of medical students who experienced online learning during the COVID-19 pandemic and to explore the adaptations to online learning. METHODS: This is an interpretive phenomenological study using purposive sampling. Participants were 1st to 3rd year medical students enrolled for Academic Year 2020-2021. Participants were interviewed online by a psychologist who was not part of the research team using a 13-question guide. The interviews were recorded and transcribed. Interview data were analyzed and interpreted using interpretative phenomenological analysis (IPA). RESULTS: Nine medical students were interviewed. The IPA identified six superordinate themes: 1) positive adaptations through positive reframing; 2) resulting mental health concerns; 3) intrinsic and extrinsic concerns encountered; 4) self-awareness as a first step towards adjustment; 5) dual role of family; and 6) perceptions on systemic response. CONCLUSION Online medical education during the pandemic resulted in problems and mental health concerns among participants, and many developed self-awareness and positive adaptations specific to the online setup. Participants’ families helped some adjust, while others posed an additional challenge. Both positive and negative perceptions of the systemic response of the school also arose.

BACKGROUND AND PURPOSE: Prediction of intracranial aneurysm growth risk can assist physicians in planning of follow-up imaging of conservatively managed unruptured intracranial aneurysms. We therefore aimed to externally validate the ELAPSS (Earlier subarachnoid hemorrhage, aneurysm Location, Age, Population, aneurysm Size and Shape) score for prediction of the risk of unruptured intracranial aneurysm growth. METHODS: From 11 international cohorts of patients ≥18 years with ≥1 unruptured intracranial aneurysm and ≥6 months of radiological follow-up, we collected data on the predictors of the ELAPSS score, and calculated 3- and 5-year absolute growth risks according to the score. Model performance was assessed in terms of calibration (predicted versus observed risk) and discrimination (c-statistic). RESULTS: We included 1,072 patients with a total of 1,452 aneurysms. During 4,268 aneurysm-years of follow-up, 199 (14%) aneurysms enlarged. Calibration was comparable to that of the development cohort with the overall observed risks within the range of the expected risks. The c-statistic was 0.69 (95% confidence interval [CI], 0.64 to 0.73) at 3 years, compared to 0.72 (95% CI, 0.68 to 0.76) in the development cohort. At 5 years, the c-statistic was 0.68 (95% CI, 0.64 to 0.72), compared to 0.72 (95% CI, 0.68 to 0.75) in the development cohort. CONCLUSIONS: The ELAPSS score showed accurate calibration for 3- and 5-year risks of aneurysm growth and modest discrimination in our external validation cohort. This indicates that the score is externally valid and could assist patients and physicians in predicting growth of unruptured intracranial aneurysms and plan follow-up imaging accordingly.
Aneurysm ; Calibration ; Cohort Studies ; Discrimination (Psychology) ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Risk Factors ; Subarachnoid Hemorrhage